The Journal of burn care & rehabilitation
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Patients rely on the Internet for medical information. It is difficult to discern which resources are accurate or appropriate for patients. The purpose of this study was to develop a quality-assessment tool for health Internet Web sites and to apply this tool to assess the quality of burn scar management information on the Internet. ⋯ Using our health information evaluation, we found that the majority of burn scar management information on the internet (77%) was of fair or poor quality. Academic and organizational Web sites had the best quality of burn scar management information. Additional testing of the developed tool will be needed to analyze the reproducibility of the results and their applicability in other medical domains.
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Speech-language pathologists (SLPs) provide intervention for communication challenges and swallowing disorders (dysphagia) that are common in cases of severe burns because of ventilator use, prolonged or multiple intubations, and tracheostomy tubes. To identify current inclusion of SLP services in burn care management, a survey was sent to 139 burn units across the United States. ⋯ Education of burn care teams on the benefits of SLP inclusion is needed. Potential benefits in pain and medical management reducing length of hospitalization and increasing cost-effective care by inclusion of SLPs in burn care management warrants further research.
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J Burn Care Rehabil · May 2003
Comparative StudyTranscardiopulmonary thermal dye versus single thermodilution methods for assessment of intrathoracic blood volume and extravascular lung water in major burn resuscitation.
The purpose of this study was to compare the approximated values for intrathoracic blood volume (ITBV) and extravascular lung water (EVLW) obtained from a single indicator dilution to the exact data measured by double-indicator dilution. Eighteen patients with an average TBSA of 46.3% (range, 26 to 67%) and an average abbreviated burn severity index of 8.7 (range, 7 to 11) were included into a intraindividual comparative prospective study over a 20-month period. The COLD Z-021 system (Pulsion Medical Systems, Munich, Germany) was used to obtain both the exact measurements, as well as the estimated values for ITBV and EVLW. ⋯ Transcardiopulmonary single thermodilution is not suitable to assess intrathoracic blood volume and extravascular lung water in burn shock. However, the method is suitable to assess cardiac output and its derived parameters in burn resuscitation as shown in previous studies. It still must be proven whether the exactly measured ITBV obtained from transcardiopulmonary double-indicator dilution is superior to the commonly used parameters to guide major burn resuscitation.
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Necrotizing fasciitis is a rapidly progressive soft-tissue infection associated with significant morbidity and mortality. Necrotizing fasciitis is similar to invasive burn wound infection in that diagnosis requires histologic examination of affected tissue and treatment requires aggressive surgical debridement followed by skin autograft. Transfer to a burn center facilitates the management of necrotizing fasciitis, where requisite surgical and nursing expertise is available. ⋯ Both fatalities were associated with delay in initial surgical procedure and in transfer to the burn center. The similarity of necrotizing fasciitis and invasive burn wound infection makes the burn center the ideal setting for the treatment of this disease. We advocate the addition of necrotizing fasciitis to the list of conditions currently recognized by the American Burn Association as appropriate for burn center transfer and care.